Lentis/Sick Building Syndrome

Although sick building syndrome was not recognised before 1980[1], today it is defined by the Environmental Protection Agency (EPA) as a situation where a building’s occupants experience acute health effects that seem to be linked to time spent in a building, but no specific cause can be identified[2]. Symptoms are claimed to include headaches, eye, nose or throat irritation, coughing, itchy skin, dizziness, nausea and fatigue and most sufferers report relief soon after leaving the building. What makes sick building syndrome an interesting phenomenon is the fact that it is defined by its lack of explanation and once a specific cause has been identified, it is no longer a sick building.[1]

Contents

Sick Building Syndrome at the EPA Headquarters

In the United States, the first, most influential case of sick building syndrome occurred in the EPA’s headquarters in southwest D.C. The building was originally built for apartments in 1970 but converted to an office building for the EPA in 1971. Working conditions were poor with tiny offices, few windows, roaches, mice and clogged ventilation grills that left a black powder on surfaces. In 1987, the building owners installed new carpet to try and improve conditions.

EPA Headquarters at Waterside Mall

Many EPA employees reported sickness starting in 1988, a year after the Waterside renovations. Senior attorney, Amy Svoboda, worked in the EPA headquarters in SW DC. In 1988, she began to develop flu-like symptoms, as well as experiencing hearing loss, swollen joints, burning lungs, nausea, welts, and a loss of coordination. By 1989, Amy claimed to have forgotten how to drive and even how to operate an elevator. Amy, 35 years old at the time, played soccer and ran the stairs in the office for exercise during her lunch breaks, but the symptoms she experienced at work prevented her from continuing to do so and eventually remained with her even at home. Now she claims that she is so chemically sensitive, that in order to read a magazine at home, it must first be aired out and then put in a reading box with a fan to blow the chemicals from the printing process away from Amy[3].

Amy was not the only one feeling ill-effects from work. Kirby Biggs, an analyst for the EPA, found that he could no longer read spreadsheets because, he says, it felt like he was making a paper cut across his eyeballs. Another woman worked as a hazardous waste expert. At the age of 44, her hair turned completely white and she had trouble walking. Despite previously being a professional violinist, after prolonged Building indoor air exposures at EPA, having become sensitized to small amounts of a variety of classes of chemicals, she found she could not dial her phone for many weeks without many attempts following airborne exposure to Dimillin, a pesticide sprayed by a Fairfax County, VA helicopter in an attempt kill the yearly crop of gypsy moth larvae. This occurred while she worked at home.

Two hundred twenty five EPA employees reported burning eyes, headaches or other symptoms to an EPA nurse shortly after the renovations[1]. The sick workers were from all over the building, so many thought that their illness was unique. Amy said that it was not until a survey was sent around inquiring about health symptoms that she connected her maladies to the building[3].

After many complaints, the facilities management performed an air quality test of the building. They found 68 airborne chemicals but at no higher concentrations, they say, than in your home living room[1]. Despite the study, some employees used gas masks at work. "Spin">Pratt, Sarah Who the Hell is Sarah Pratt?. (1996, December). Every Breathe She Takes. Spin, 12, 110-181.</ref>. Other employees staged a protest outside of the building with signs that read “Canaries in a Coal Mine”[1].

Not everyone working at Waterside experienced health symptoms while at work. One employee said he never felt ill. He remembers a pungent smell the day the roof was re-tarred, but it had no physical effect on him[3].

EPA scientist, Lance Wallace, conducted his own study two years after the carpet’s installation and, again, found no acute doses of any specific chemical[1]. His study, however, included a questionnaire for all of the building’s occupants and showed that 24% of the employees of the building’s occupants felt sick at work[4]. Wallace’s only conclusion was that if there even was an exposure, it has been too masked by the psycho-social contributor to know of its true effects[1].

Nineteen people sued S.E.W. Investors, the building owners, for permanent brain damage caused by the building. Even the trial was difficult because of their chemical sensitivity. One claimant, for example, could not come within four feet of her lawyer because his dry-cleaned suit bothered her[3]. At first, the 19 were awarded $250,000 each ruling that it did not matter if the causes of their poor health were physiological or physical. Later, this ruling was overturned and the court declared that the owners were not responsible for the “psychogenetic illnesses”[1].

Probable Causes

The US National Institute for Occupational Safety and Health has cited poor ventilation systems, microbial contamination, strong indoor pollution sources, and pollutants from outside as possible contributors to sick building syndrome[5].

Inadequate Ventilation

During the oil crisis of the 1970’s, a need for energy conservation led to a reduction in the amount of outdoor air provided for ventilation. However, it was later found that these reduced ventilation rates were not adequate to maintain the comfort of the building’s occupants and contributed to the effects of SBS[2]. Inadequate ventilation may also be a source of micro-organisms and enhance the effects if indoor pollutants[5].

Biological Contaminants

Bacteria, molds, and viruses can breed in stagnant water that accumulates ducts, humidifiers, carpeting, insulation or other areas. These contaminants can then trigger physical symptoms in sensitive occupants and are often the result of poor building maintenance[2].

Indoor Contaminant Sources

Indoor air pollution can come from sources such as adhesives, carpeting, upholstery, copy machines and cleaning products. These sources emit volatile organic compounds (VOCs) which can produce acute reactions in people even in low or moderate levels. Tobacco smoke produces high levels of VOCs. In fact, when people are allowed to smoke indoors, approximately 30% of occupants will complain of environmental discomfort[2].

Outdoor Contaminant Sources

Outdoor air pollutants such as vehicle exhaust can enter buildings through air intake vents, windows or other openings. These pollutants then become a form of indoor air pollution and can cause discomfort[2].

Psychological Aspects

There is considerable debate as to whether or not sick building syndrome should be considered a medical condition or if symptoms are merely psychological. This is mostly likely because although many probable causes exist, symptoms cannot be traced to a specific origin. Additionally, symptoms have been shown to increase along with factors such as job stress, time spent in front of a computer screen, and decreased job status[5]. In fact, in every study in which work stress has been considered as a factor, it was clearly correlated with SBS symptoms[5]. This suggests that sick building syndrome may be a disease that exists only in the head. However, if it is purely psychological, how does one explain instances like the one at the EPA headquarters where building occupants are legitimately sick? For now, a building is to be considered sick when 20% or more of its occupants complain of illnesses that are linked to time spent in that building[4].

Social Groups

Building Occupants

Many groups of people are affected by sick building syndrome. In the case of the EPA headquarters, female employees initially reported symptoms to the EPA nurse much more frequently than men. Doctors were initially instructed to attribute these symptoms in women to “mass hysteria triggered by stress and the female coping style or menstrual irregularities” ”[1]. However, over time, more and more men reported symptoms, causing doctors and other health experts to pay more attention to these health complaints. In addition to the employees suffering from symptoms, all employees in the office were affected by sick building syndrome. Because the symptoms caused affected employees to call out of work sick and to be less productive while at work, other employees were required to do more work to make up for their coworkers’ lack of performance. Employers also became increasingly concerned with the symptoms their employees were reporting, as productivity in the office dropped.

Occupational Health Experts

Facilities management employees and occupational health experts play a key role in determining whether there is a technical explanation to symptoms. While they may not have been able to determine a cause in the case of the EPA headquarters, their role is crucial in determining the possibilities of airborne chemicals being present.

Building Owners

At the other end of the spectrum, building owners are now potentially liable for the adverse health effects caused by their buildings. Owners must be concerned for the health of their building occupants, because many sick building syndrome lawsuits have occurred between building occupants and owners. Personal injury lawyers have become increasingly common in sick building syndrome cases, some even listing sick building syndrome as a specialty[6].

Responses to Complaints

US Green Building Council’s (USGBC) Leadership in Energy and Environmental Design (LEED) standards express concerns about ventilation in buildings. It is possible to gain additional credits toward a certified building by providing increased ventilation, in addition to what is required. Emphasis is also placed on the comfort of the building occupants, by providing credits toward certification for allowing occupants access to temperature and lighting controls. The measures taken by USGBC illustrate the importance that is now being placed on the comfort and safety of building occupants[7].

The US Environmental Protection Agency (EPA) has also issued information on Federal Facilities Indoor Air. They provide tips on how to create a healthy indoor environment, saying a building occupant’s surroundings should “contribute to productivity, comfort, and a sense of well-being”[8]. They have also created a list (Building Air Quality Action Plan) of preventative measures that can be taken in order to prevent building occupants from experiencing sick building syndrome symptoms. A large emphasis in this list is put on communication between building occupants, managers and owners. It encourages getting everyone involved in making buildings healthy and safe environments[8].

Moral

In general, at first, health experts tried to convince patients that their symptoms were purely psychological, being traced back to women’s menstrual cycles or healthy reactions to work. Over time, however, as more and more people reported symptoms, it became more obvious that there was a problem that needed to be addressed.

Similar to the case of "fan death" in South Korea, there is no technical explanation for the symptoms described. Although no technical explanation has been identified (i.e., poor indoor air quality), because so many people have complained about symptoms, some type of solution had to be devised in order to satisfy the general public.

Because sick building syndrome is a fairly recent issue, any professionals currently involved in design of buildings should be aware of the problem. Engineers and architects will play a key role in the future of designing buildings with the occupants in mind. By beginning to think about the building occupants before construction, it may be possible to decrease the number of people affected by sick building syndrome.